Shameless Self-Promotion – Nitrous Oxide for Labor Pain

Today the Agency for Healthcare Research and Quality (AHRQ) released the final version of the comparative effectiveness review, “Nitrous Oxide for the Management of Labor Pain.” Nitrous oxide is commonly used in the UK and other countries to help women cope with labor, but is only available at about 5 places in the United States for this purpose.

This systematic review of the evidence looks at existing evidence on how well nitrous oxide compares to other methods (like epidurals) for relieving labor pain, women’s satisfaction with their birth experience and pain management, any effects on route of birth (i.e., cesarean vs. vaginal), and potential adverse effects.

And, hey, look who’s a co-author. 🙂

A big part of the findings was that more research is needed. It’s no surprise that nitrous doesn’t seem to offer as complete pain relief as epidural – it’s not intended to, and women who choose it know that going in. However, it may be a viable option for women who want to avoid or delay epidural, something covered in the discussion. The side effects seem pretty mild, but more and better studies are needed on a number of issues, like, as the report indicates:

• Exploring anti-anxiety effects of nitrous oxide during labor.
• Examining the influence of nitrous oxide on whether and when women choose to use other labor pain management methods.
• Investigating the impact of nitrous oxide on use of cointerventions, route of birth, maternal-newborn bonding, and breastfeeding.
• Assessing fetal/neonatal clearance of nitrous oxide.
• Determining optimal methods for minimizing occupational exposures, such as room
ventilation and scavenging measures.
• Assessing potential occupational harms, including nitrous oxide abuse and addiction.
• Identifying health system factors influencing the use of nitrous oxide for the management of labor pain, including but not limited to provider preferences, availability, setting, and resource utilization.
• Determining provider and patient education needed for nitrous oxide use in labor,
• Analyzing cost effectiveness of nitrous oxide and other labor pain management methods.

Anyway, check it out. It’s freely available online, because it’s a government-funded report.

PS – Heard about AHRQ lately? It might be because Republicans are trying to defund it. I speculate about why in a recent post over at Our Bodies Our Blog.